International journal of pediatric otorhinolaryngology最新文献

{"title":"Utility of interval direct laryngoscopy and bronchoscopy in tracheostomy-dependent infants: A retrospective longitudinal chart review","authors":"Alexander Szymczak ,&nbsp;Reyna Patel ,&nbsp;Steven Tomasi ,&nbsp;Rhea Verma ,&nbsp;Ashley Young ,&nbsp;Saied Ghadersohi ,&nbsp;Jonathan Ida ,&nbsp;Inbal Hazkani","doi":"10.1016/j.ijporl.2025.112390","DOIUrl":"10.1016/j.ijporl.2025.112390","url":null,"abstract":"<div><h3>Background</h3><div>Tracheostomies are increasingly utilized in children with respiratory compromise, necessitating routine direct laryngoscopy and bronchoscopy (DLB) to confirm airway patency and manage complications. The timing and frequency of interval DLB in children lack consensus due to insufficient evidence-based data. Our study aims to evaluate the utility of interval DLB in tracheostomy-dependent infants.</div></div><div><h3>Methods</h3><div>Retrospective case-series of infants who underwent tracheostomy at ≤ 2 years of age at a tertiary children's hospital, with at least 1 year of follow-up.</div></div><div><h3>Results</h3><div>There were 52 patients who underwent 430 DLBs. Median age at time of tracheostomy was 5.29 [4.72] months. Most patients were male (n = 29, 55.8 %) and white (n = 22, 42.3 %). Significant comorbidities included hypotonia (n = 40, 79.9 %), bronchopulmonary dysplasia (n = 29, 55.8 %), syndromic/genetic disorders (n = 26, 50.0 %), and structural cardiac abnormalities (n = 22, 42.3 %). Median gestational age was 34 ± 6.2 [IQR = 13] weeks. A median interval of 5.29 [IQR = 4.63] months occurred between DLBs. Common surgical interventions included intra-luminal granulation tissue removal and endoscopic dilation with overall intervention rates of 26.8 %, 37.5 %, 28.6 %, 26.8 %, 25.0 %, and 17.9 % on DLB 1–6, respectively. An intervention in DLB2 (6.2 months) or DLB3 (10.6 months) was associated with a higher percent intervention in subsequent DLBs during the study period (p = 0.002). Other comorbidities such as age at tracheostomy, mechanical ventilation, and gestational age were not associated with a greater need for intervention.</div></div><div><h3>Conclusions</h3><div>Interval DLB in tracheostomy-dependent infants frequently involves surgical interventions, regardless of demographic or medical factors, underscoring the role of surveillance DLB.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"194 ","pages":"Article 112390"},"PeriodicalIF":1.2,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144072143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of prenatal exposure to lead and mercury with auditory function in infants","authors":"Sandra Fortin ,&nbsp;Benoît Jutras ,&nbsp;Maryse F. Bouchard ,&nbsp;Linda Booij ,&nbsp;Gina Muckle ,&nbsp;Bruce Lanphear ,&nbsp;Dave Saint-Amour","doi":"10.1016/j.ijporl.2025.112393","DOIUrl":"10.1016/j.ijporl.2025.112393","url":null,"abstract":"<div><h3>Purpose</h3><div>This study examined the association between lead (Pb) and mercury (Hg) exposure during early brain development with auditory function in infants.</div></div><div><h3>Methods</h3><div>Auditory function of six-month-old infants from the Maternal-Infant Research on Environmental Chemicals-Infant Development (MIREC-ID) cohort was assessed with minimal auditory response levels (MRLs) to warble tones and speech in soundfield, tympanometry, and otoacoustic emissions (OAEs; transient – TEOAEs; and distortion product – DPOAEs). Pb and total Hg concentrations in blood samples were obtained at three time points: maternal blood samples at the first and third trimesters of pregnancy, and umbilical cord blood samples at birth.</div></div><div><h3>Results</h3><div>Higher maternal blood Pb concentrations during pregnancy were significantly related with low OAEs. The associations were stronger for TEOAEs, in particular TEOAE reproducibility, than DPOAEs, and were stronger in the left ear compared with the right ear for TEOAEs. Pb was barely associated with MRLs. No clear evidence of association between Hg exposure and auditory function (OAEs and MRL) was found.</div></div><div><h3>Conclusions</h3><div>Developmental exposure to low Pb concentrations are associated with a reduction of outer hair cells responses to sounds, suggestive of a decrease in inner ear function. Further studies are needed to verify these results in a larger sample of infants.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"194 ","pages":"Article 112393"},"PeriodicalIF":1.2,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of demographic background and postoperative outcome of unilateral, sequential, and simultaneous cochlear implantation in pediatric patients","authors":"Hajime Koyama,&nbsp;Akinori Kashio,&nbsp;Erika Ogata,&nbsp;Yusuke Akamatsu,&nbsp;Kenji Kondo","doi":"10.1016/j.ijporl.2025.112391","DOIUrl":"10.1016/j.ijporl.2025.112391","url":null,"abstract":"<div><h3>Objective</h3><div>This study retrospectively examined cochlear implantation (CI) decisions in children with bilateral hearing loss, comparing unilateral, sequential, and simultaneous implantation approaches.</div></div><div><h3>Methods</h3><div>The analysis included 102 children aged &lt;6 years who underwent CI. The patients were categorized into unilateral, sequential, and simultaneous groups based on their implantation strategies. Factors influencing the initial CI decision were categorized into audiological, anatomical, and social factors, and the differences among the three groups were analyzed. The change in aided thresholds between the preoperative and postoperative periods was also investigated.</div></div><div><h3>Results</h3><div>Simultaneous implantations increased over time. A total of 75 % of the patients who received unilateral CI for audiological reasons later underwent CI on the other side. Sequential implantation tended to have worse postoperative thresholds with a hearing aid (HA) compared to preoperative levels with an HA. Only 44 % of patients with unilateral CI could effectively use a contralateral HA, and none of them achieved better speech recognition with an HA in the contralateral ear than in the CI implanted side.</div></div><div><h3>Conclusion</h3><div>There is little evidence supporting unilateral CI in candidates without anatomical or social limitations, and simultaneous CI is recommended.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"194 ","pages":"Article 112391"},"PeriodicalIF":1.2,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myhre syndrome: Endoscopic airway presentation","authors":"Nicole Wershoven ,&nbsp;Lauren Maloney ,&nbsp;Jacyln Souder ,&nbsp;Indira Sriram ,&nbsp;Peter R. Baker II ,&nbsp;Jeremy D. Prager","doi":"10.1016/j.ijporl.2025.112372","DOIUrl":"10.1016/j.ijporl.2025.112372","url":null,"abstract":"","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"194 ","pages":"Article 112372"},"PeriodicalIF":1.2,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shared Perspectives: Evaluating the impact of tracheostomy on quality of life through the voices of children and their parents","authors":"Michelle Fong ,&nbsp;Beth Osterbauer ,&nbsp;My H. Vu ,&nbsp;Nicole Anderson ,&nbsp;Elizabeth Franco ,&nbsp;Christian Hochstim","doi":"10.1016/j.ijporl.2025.112386","DOIUrl":"10.1016/j.ijporl.2025.112386","url":null,"abstract":"<div><h3>Background</h3><div>There is a significant morbidity burden associated with tracheostomy in children as well as the physical, time, and financial burdens on their caregivers. We aimed to assess how living with a tracheostomy impacts the quality of life of patients and their caregivers compared to children without tracheostomy.</div></div><div><h3>Methods</h3><div>A cross sectional study was conducted of children attending the outpatient otolaryngology clinic at a tertiary urban children's hospital. All parents completed the Pediatric Quality of Life Inventory™ (PedsQL) 4.0 and the PedsQL™ Family Impact Module questionnaires. Children 5 years of age and older completed the age group specific PedsQL™ 4.0 Child Report.</div></div><div><h3>Results</h3><div>Mean scores for the Family Impact Module (FIM) were significantly lower in the tracheostomy group as compared to the controls (68.9 [SD 20] vs. 79.7 [SD 16], p = 0.004) representing more reported problems. The biggest differences in the parents' report on their children's quality of life were seen in the social functioning and cognition of the children (66.1 [SD 25.8] vs. 82.3 [SD 19.7], p &lt; 0.001; and 58.0 [SD 27] vs. 72.2 [SD 23.5], p = 0.01, respectively). Additionally, parent reported scores for their children were highly correlated with their children's self-reports (R = 0.44, p = 0.002).</div></div><div><h3>Conclusion</h3><div>We describe a novel measurement among tracheostomy patients of children's self-reported quality of life. Physicians and care teams involved in caring for children living with tracheostomy should be aware of the wide-ranging impacts on the quality of life for the entire family and be prepared to offer appropriate resources.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"194 ","pages":"Article 112386"},"PeriodicalIF":1.2,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidisciplinary approach to airway management in Pierre Robin sequence: beyond tracheostomy","authors":"Thirunavukkarasu Saravanamuthu ,&nbsp;Pravilika Parachur ,&nbsp;M.D. Sofitha ,&nbsp;Naveen kumar Jayakumar ,&nbsp;Chandra Kumar Natarajan","doi":"10.1016/j.ijporl.2025.112384","DOIUrl":"10.1016/j.ijporl.2025.112384","url":null,"abstract":"<div><h3>Objective</h3><div>Pierre robin sequence (PRS) is characterized by a triad of cleft palate, micrognathia and glossoptosis leading to upper airway obstruction with feeding difficulties. Objective of our study is to share our experience on how children with Airway problems in PRS can be managed without the need for tracheostomy by Multidisciplinary approach for evaluation and management.</div></div><div><h3>Methods</h3><div>A retrospective review of 33 patients between April 2014–Dec 2022 diagnosed with PRS who were admitted to the NICU with feeding or breathing difficulties were taken into the study. Electronic data was collected and analyzed. Statistical analysis of age, gender, clinical features,intervention required and outcome were made.</div></div><div><h3>Results</h3><div>In our review of 33 patients, mean age was 2.5 months. 17 (51 %) were males and sixteen (48 %) were females. Non surgical interventions included feed establishment and placement of obturator. Surgical intervention was required in sixteen (48 %) of patients, of which 8 (24 %) underwent glossopexy, 6 (18 %)underwent supraglottoplasty and 2 (6 %) underwent tracheostomy. Of the 2 tracheostomised children one was decannulated and the other child was lost to follow up. Thirty one patients were managed without the need for tracheostomy.</div></div><div><h3>Conclusion</h3><div>Prior to considering tracheostomy as a bypass to upper airway obstruction commonly seen in PRS children, a multidisciplinary approach for evaluation providing combined conservative and airway intervention can be beneficial and thereby improving the QoL.</div><div>Significance to aerodigestive medicineAerodigestive medicine has a significant role in addressing the two major problems in management of PR sequence - feeding and respiratory difficulties. Prompt evaluation and effective intervention can ensure optimal function of the aerodigestive tract.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"194 ","pages":"Article 112384"},"PeriodicalIF":1.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in pediatric otolaryngology: A state-of-the-art review of opportunities and pitfalls","authors":"Nithya Navarathna ,&nbsp;Adway Kanhere ,&nbsp;Charlyn Gomez ,&nbsp;Amal Isaiah","doi":"10.1016/j.ijporl.2025.112369","DOIUrl":"10.1016/j.ijporl.2025.112369","url":null,"abstract":"<div><h3>Background</h3><div>Artificial Intelligence (AI) and machine learning (ML) have transformative potential in enhancing diagnostics, treatment planning, and patient management. However, their application in pediatric otolaryngology remains limited as the unique physiological and developmental characteristics of children require tailored AI applications, highlighting a gap in knowledge.</div></div><div><h3>Purpose</h3><div>To provide a narrative review of current literature on the application of AI in pediatric otolaryngology, highlighting knowledge gaps, associated challenges and future directions.</div></div><div><h3>Results</h3><div>ML models have demonstrated efficacy in diagnosing conditions such as otitis media, adenoid hypertrophy, and pediatric obstructive sleep apnea through deep learning-based image analysis and predictive modeling. AI systems also show potential in surgical settings such as landmark identification during otologic surgery and prediction of middle ear effusion during tympanostomy tube placement. Telemedicine solutions and large language models have shown potential to improve accessibility to care and patient education. The principal challenges include flawed generalization of adult training data and the relative lack of pediatric data.</div></div><div><h3>Conclusions</h3><div>AI holds significant promise in pediatric otolaryngology. However, its widespread clinical integration requires addressing algorithmic bias, enhancing model interpretability, and ensuring robust validation across pediatric population. Future research should prioritize federated learning, developmental trajectory modeling, and psychosocial integration to create patient-centered solutions.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"194 ","pages":"Article 112369"},"PeriodicalIF":1.2,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the postoperative analgesic effects of bupivacaine and ropivacaine in infraorbital nerve block anesthesia for cheiloplasty in infants","authors":"Wenjie Zhou ,&nbsp;Yilin Li ,&nbsp;Nan Lin ,&nbsp;Zhiyu Cai ,&nbsp;Chuanqing Mao ,&nbsp;Yongzhen Lai ,&nbsp;Meng Lu","doi":"10.1016/j.ijporl.2025.112373","DOIUrl":"10.1016/j.ijporl.2025.112373","url":null,"abstract":"<div><h3>Obejective</h3><div>This prospective study aimed to evaluate the analgesic efficacy of ropivacaine and bupivacaine for infraorbital nerve block following cheiloplasty. Additionally, it investigated the safety and feasibility of these agents in infants and young children.</div></div><div><h3>Methods</h3><div>Participants were divided into three groups: Control (physiological saline), Group L (ropivacaine), and Group B (bupivacaine). Bilateral infraorbital nerve block anesthesia was performed at the beginning of surgery, followed by general anesthesia for the procedure. Postoperative pain was scored using the FLACC scale.</div></div><div><h3>Results</h3><div>Group B had a significantly lower heart rate post-surgery compared to the other groups (P &lt; 0.05). FLACC pain scores at 30 min, 1 h, and 4 h post-surgery were significantly lower in Groups L and B compared to the control group (P &lt; 0.05). Side effects included edema, hematoma, nausea, vomiting, cyanosis, and convulsions, with no adverse reactions in the control group. Group L had one case of lip cyanosis and convulsions, and Group B had one case of nausea and vomiting. No significant differences were found in age, weight, and surgical time among the three groups (P &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>Ropivacaine showed similar analgesic effects to bupivacaine but with higher safety for postoperative pain relief in cleft lip repair in infants and young children, suggesting its clinical utility.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"193 ","pages":"Article 112373"},"PeriodicalIF":1.2,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143902357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of parental anxiety and catastrophizing on post-tonsillectomy opioid consumption in children","authors":"Tanya Chen ,&nbsp;Jennifer M. Siu ,&nbsp;Bradley Hubbard ,&nbsp;Thileep Kandasamy ,&nbsp;Janet Chung ,&nbsp;Melanie Noel ,&nbsp;Brittany N. Rosenbloom ,&nbsp;Jackie Chiang ,&nbsp;Indra Narang ,&nbsp;Evan J. Propst ,&nbsp;Nikolaus E. Wolter","doi":"10.1016/j.ijporl.2025.112374","DOIUrl":"10.1016/j.ijporl.2025.112374","url":null,"abstract":"<div><h3>Background</h3><div>The impact of parental psychological factors on post-operative pain management in children is not well understood, but is important. The aim of this study was to determine the relationship between parental anxiety, pain catastrophizing about child pain, and opioid administration in children undergoing tonsillectomy.</div></div><div><h3>Methods</h3><div>This was a multicenter prospective cohort study from four different centers between 2022 and 2023. All parents of children undergoing adenotonsillectomy were included. Parental levels of anxiety and pain catastrophizing were assessed using the State-Trait Anxiety inventory (STAI), a Numeric Anxiety Scale (NAS), and the Pain Catastrophizing Scale-Parent Version (PCS-P). Post-operative analgesia data was collected on post-operative days (POD) 1, 3, 7, and 10.</div></div><div><h3>Results</h3><div>236 patients were included. Mean child age was 5.1 years old (SD 2.8). Mean baseline parental PCS-P score was 34.4 and NAS was 6.1. Higher PCS-P and NAS scores corresponded to increased odds of opioid administration in the early postoperative period (POD 1 and 3 [aOR 1.16, 95 % CI [1.03–2.99])). Children with a communication delay (aOR 4.75, 95 % CI [2.35–9.59]) and young children (aOR 1.73, 95 % CI [1.45–2.56]) also had increased opioid administration in the early postoperative period (POD1 &amp; 3).</div></div><div><h3>Conclusion</h3><div>Parents who have higher anxiety and tendencies to catastrophize are more likely to administer opioids early in the postoperative period. Children with limited communication skills are more likely to receive greater amounts of opioids after tonsillectomy. Interventions such as targeted screening for parental mental health, peri-operative counseling, and tailored pain control programs represent promising avenues for improving pain management.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"194 ","pages":"Article 112374"},"PeriodicalIF":1.2,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of dedicated inpatient rounds on tracheostomy care in children","authors":"Zialesi W Adissem ,&nbsp;Jordan I. Gewirtz ,&nbsp;Isaac Kistler ,&nbsp;Jemma Maynard ,&nbsp;Jeffrey S. Criswell ,&nbsp;Caroline M. Buck ,&nbsp;Tendy Chiang ,&nbsp;Prasanth Pattisapu ,&nbsp;Amy Manning","doi":"10.1016/j.ijporl.2025.112375","DOIUrl":"10.1016/j.ijporl.2025.112375","url":null,"abstract":"<div><h3>Objective</h3><div>To describe our institution's weekly multidisciplinary tracheostomy team (MDT) rounds and assess their effect on increasing routine surveillance and low acuity interventions for patients with tracheostomies under two years of age.</div></div><div><h3>Study design</h3><div>Retrospective.</div></div><div><h3>Setting</h3><div>Tertiary referral children's hospital.</div></div><div><h3>Methods</h3><div>All inpatient encounters below age two with an existing tracheostomy were included. Patients receiving tracheostomies during their admission were excluded. All comparisons were made between admissions one year before and after implementation of tracheostomy team rounds.</div></div><div><h3>Results</h3><div>One hundred thirty admissions (43 unique patients, 51 % female) were found, of which 56 occurred one year before the start of weekly rounds. Twenty-three percent of admissions were related to the patient's tracheostomy. Rounds increased otolaryngology encounters during an admission (OR: 2.38, 95 % CI [1.16, 4.89], p = 0.018). Stomal concerns noted during admission decreased with the implementation of rounds (OR: 0.13, 95 % CI [0.03, 0.66], p = 0.014). The number of surveillance direct laryngoscopy and bronchoscopy <strong>(</strong>DLB) preformed as recommend from MDT rounds increased after the implementation of rounds (OR 5.58, 95 % CI [2.09, 14.9], p &lt; 0.001) as did other interventions recommended during rounds but not done immediately at bedside (OR 9.66, 95 % CI [3.40, 27.5], p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Aspects of care for children less than two years of age with tracheostomies were improved after implementation of the multidisciplinary tracheostomy team. Increased surveillance and access to lower acuity, lower risk care were seen with weekly, dedicated MDT ward-rounds.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"194 ","pages":"Article 112375"},"PeriodicalIF":1.2,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143928078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}